Hasn’t he brought us through the decades, guiding us stage by stage toward the present? Hasn’t he opened the way toward a health care loyal to the singular stories of those for whom we care? Hasn’t he opened the way toward a kind of writing loyal to the singular situation of those of whom we write?
Dr. Oliver Sacks has been an always-present presence for the worlds of literature, medicine, narrative, and health. I certainly don’t know this world of ours without him in it. When he died, even though he had been so tender toward us in his gentle warnings that the end was near, I was shocked. It was as if one of the planets had been extinguished.
Dr. Sacks developed an epistemology, not of knowledge alone but of an artist’s means of seeing. In Sacks, seeing became knowing, and knowing encompassed caring. The knowledge base was prodigious, not only of neurology but of musicology, literature, marine biology, and chemistry. He was smitten by the human brain and in his life lifted many forms of darkness from it. His avarice for experience drew knowledge to him, whether about hallucinogens, body building, or surfing off the California coast.
I remember once inviting Dr. Sacks to a conversation with a group of medical students at Columbia University. This was early on, perhaps the mid-1980s. He was working at Albert Einstein College of Medicine and the Beth Abraham Hospital then, living on City Island in the Bronx. Having lived on the island myself during college and having a clear picture in my mind of the street on which he lived, I felt a kinship if only by way of knowing how City Island Avenue seems to widen midway in its stretch from the bridge to the last marina, right around where the usually empty little city park breaks the facade of one fish restaurant after another.
He would have that pause in his day: the crossing of the bay bridge onto the island. He must have been a misfit on that little island of firemen and fishermen. Whatever did his neighbors make of him — a Brit, a doctor, living alone, working often into the night? Writing this now and thereby thinking about it, I see that perhaps City Island was exactly where in New York City Sacks could live — without pretension, without elites, without the need for contact unless you really wanted it, a parenthesis away from the “real” city, a parenthesis away from the real. He never did make the presentation at Columbia because of unexpected travel, but even the thought that he wanted to do it was important to my students and me. It let us feel that we were part of his universe.
Years later, when we were on the faculty together at Columbia, we began to see how our fields—his of Sacks-ian writing and mine of narrative medicine—were neighbors. I remember one session after a Psychiatry Institute lecture when we hosted a large group of residents. We felt our kinship then, as doctors interested in the lives of the persons we treat and also as doctors who find some path toward perceiving, through writing, how we could help our patients. I was grateful that he delivered one of my Narrative Medicine Rounds, the most well attended of my Rounds for many years.
In the early days, he was one of the very few influential persons who permitted a professional interest in language in medicine. You could always point to Oliver Sacks—and sociologist Elliot Mishler and physician and essayist Lewis Thomas—as your warrant for paying attention to stories. He gave us cover as we developed narrative medicine and health humanities. But who gave him cover? Neuropsychologist A.R. Luria was dead. Anton Chekhov was dead. Dr. Sacks was out there in the cold, doing his work, writing his cases, seeing poor patients in the Bronx with their strokes or multiple sclerosis or movement disorders. Did they know of his stature? Did they know that their doctor was a nonpareil? Did they read what he wrote about other patients, wondering if maybe he would write something about them?
What must it have been like to be one of the patients he wrote about? Clive, the musician and musicologist who suffered herpes encephalitis and lost all memory, living with the horror of believing he was already dead. In describing the patient’s plight, Sacks makes it unforgettable, impermissible, as if the reader now has a stake in its never happening again. Did Clive read what Sacks wrote about him? If he did, if he could, he must have discovered himself anew. And in the process of revealing Clive, Sacks reveals something about himself—maybe not to the patient but certainly to his readers. Over all these years, these years of writing about patients, about Schumann, about deafness, autism, chemistry equations, his parents and uncle, he showed us the mind and spirit of Oliver Sacks.
The older and sicker he got, the more he trusted us, his readers. He revealed his sexual orientation just at the very end of his life. He told of his simple pleasures — like gefilte fish, prepared first by his mother and at the end by a housekeeper who figured out Jewish cuisine on her own.
Whether in a book like The Man Who Mistook His Wife for a Hat or a long-format essay in The New Yorker, Sacks’ method seems the same. He entered the narrative world of his subject with his curiosity opened wide. Probably more important, he entered with the conviction that he could make sense of what he perceived. He was convinced that if he took enough time and discernment, he would be able to see the meaning of what to others seemed bizarre or crazy. This is what he taught me: to find the right words. To believe that I could find meaning in anything if I looked hard enough and tried hard enough to represent it in words. I have come to believe that narrative saves lives. Maybe I learned this from Oliver Sacks.
He has helped us see that patients don’t only want to be cured of what ails them. They know that this is not always possible. What they crave is someone to believe them. The most grievous thing one can say to a suffering person is, “It’s all in your head.” Well-meaning doctors, nurses and therapists deliver the “good news” that there’s nothing wrong. What terrible news to a person who has been seeking answers to the why and the what of their suffering.
Dr. Sacks wrote in a measured prose, assuming an observant position both detached and committed. His emotional response to the subject’s predicament came not through the color of the prose but from the encyclopedic detail offered. His caring was enacted in his noticing. His legacy will be—is already—to commend to those who care for patients that we notice it all, that we don’t squander any piece of evidence, not just about the disease but about the person who has that disease. He fulfills Henry James’s dictum to the novelist: “Try to be one of those people on whom nothing is lost.”
We have lost more than a hero. We have lost the living evidence that such seeing is possible.
from Health Affairs Blog http://ift.tt/1KRPhMQ
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